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Article

Influence of Gender on Occurrence of Aseptic Loosening and Recurrent PJI after Revision Total Knee Arthroplasty

1
Center for Musculoskeletal Surgery, Clinic for Orthopedics, Charité University Hospital, 10117 Berlin, Germany
2
Laboratory of Adaptive and Regenerative Biology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
3
Sporthopaedicum, 94315 Straubing, Germany
*
Author to whom correspondence should be addressed.
Academic Editor: Redha Taiar
Received: 26 February 2021 / Revised: 12 April 2021 / Accepted: 25 April 2021 / Published: 17 May 2021
(This article belongs to the Special Issue Bone Biomechanics: Diseases, Treatment and Rehabilitation)
Background: Periprosthetic joint infection (PJI) is a common yet severe complication after total knee arthroplasty (TKA). Surgical intervention and antibiotic therapy are obligatory to achieve successful, infection-free outcome. Compared to the outcomes after primary TKA, prosthesis failure rates are drastically increased after PJI-dependent revision surgery. Recurrent PJI and aseptic loosening are the most common reasons for prosthesis failure after revision TKA. An open question is the influence of the patients’ gender on long-term prosthesis survival after revision surgery. Additionally, it is unknown whether gender-related parameters and risk factors or differences in treatment are responsible for potential differences in outcome after revision arthroplasty. Patients and Methods: In this report, 109 patients that received TKA revision surgery due to PJI were retrospectively analyzed. We used clinical, paraclinical and radiological examinations to study the influence of gender on the long-term complications aseptic loosening and recurrent PJI after PJI-dependent revision arthroplasty. Results: While overall prosthesis failure rates and risk of recurrent PJI did not differ between genders, the long-term risk of aseptic loosening was significantly elevated in female patients. Postoperative coronal alignment was significantly more varus for women later diagnosed with aseptic loosening. Besides coronal alignment, no gender-dependent differences in clinical presentation or treatment were observed. Conclusions: Female patients displayed a significantly increased risk for aseptic loosening after PJI-dependent revision TKA. The observed gender-dependent differences in long-term outcome in our study support theories surrounding the role of bone metabolism in the development of aseptic loosening. Our data suggest that further research on a female design for PJI-dependent revision prostheses is warranted. View Full-Text
Keywords: aseptic loosening; periprosthetic joint infection; knee arthroplasty; revision arthroplasty; sex differences; gender differences aseptic loosening; periprosthetic joint infection; knee arthroplasty; revision arthroplasty; sex differences; gender differences
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MDPI and ACS Style

Kienzle, A.; Walter, S.; Palmowski, Y.; Kirschbaum, S.; Biedermann, L.; von Roth, P.; Perka, C.; Müller, M. Influence of Gender on Occurrence of Aseptic Loosening and Recurrent PJI after Revision Total Knee Arthroplasty. Osteology 2021, 1, 92-104. https://0-doi-org.brum.beds.ac.uk/10.3390/osteology1020010

AMA Style

Kienzle A, Walter S, Palmowski Y, Kirschbaum S, Biedermann L, von Roth P, Perka C, Müller M. Influence of Gender on Occurrence of Aseptic Loosening and Recurrent PJI after Revision Total Knee Arthroplasty. Osteology. 2021; 1(2):92-104. https://0-doi-org.brum.beds.ac.uk/10.3390/osteology1020010

Chicago/Turabian Style

Kienzle, Arne, Sandy Walter, Yannick Palmowski, Stephanie Kirschbaum, Lara Biedermann, Philipp von Roth, Carsten Perka, and Michael Müller. 2021. "Influence of Gender on Occurrence of Aseptic Loosening and Recurrent PJI after Revision Total Knee Arthroplasty" Osteology 1, no. 2: 92-104. https://0-doi-org.brum.beds.ac.uk/10.3390/osteology1020010

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